Academic literature on the topic 'Treatment, Rwanda'
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Journal articles on the topic "Treatment, Rwanda"
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Chamberlin, Mary D., and Angela Lee. "A tale of two cohorts: Patients presenting for endoscopy in Kigali, Rwanda compared to an academic medical center in New Hampshire, U.S." Journal of Clinical Oncology 35, no. 15_suppl (2017): e18057-e18057. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18057.
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e18057 Background: Gastric cancer is the third leading cause of cancer death worldwide. In Rwanda and East Africs in general, gastric cancer is common in young men and women to the point where the region is known as the "stomach cancer region." Previously reported molecular profiling of Rwandan gastric cancer specimens indicate a lower mutation burden than expected based on historic western-based data; the corresponding database of endoscopy results suggests lsrge differences in access to care. This study compares a US endoscopy database to one from the University of Rwanda, to highlight the disparities of care in low and middle income countries (LMIC’s) compared to higher income countries. Methods: Retrospective pathology, demographic and radiographic data was collected from 164 Rwandan patients who presented for endoscopy at the Kigali University Teaching Hospital and compared with a matching cohort of patients at Dartmouth-Hitchcock Medical Center , Lebanon, NH (DHMC). Results: Approximately 85% of the Rwandan endoscopy cohort presented with gastric cancer, whereas none was seen in the DHMC cohort; the latter group was older than the Rwandan cohort (62.3 vs. 58.6 years). The most common indication for endoscopy among the DHMC cohort was gastroesophageal reflux disease (GERD) or anemia (72%) while the Rwandan cohort most commonly presented with pain or vomiting (68%). A matched US gastric cancer cohort revealed that 63% of US cases of gastric cancer receive treatment with curative intent compared to 7.4% of Rwandan cases. Conclusions: The Rwandan cohort presented with more severe symptoms and was more likely to be diagnosed with gastric cancer than the DHMC patients yet less likely to receive treatment with curative intent. These results highlight the disparities of care in LMIC’s and the need for improving access to early detection and curative treatments.
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Taylor, S., R. Simango, Y. Ogbolu, R. Riel, D. J. Riedel, and E. Musabeyezu. "Hepatitis C Treatment Outcomes in Kigali, Rwanda." Annals of Global Health 82, no. 3 (2016): 562. http://dx.doi.org/10.1016/j.aogh.2016.04.510.
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Uwimana, A., I. Nhapi, U. G. Wali, Z. Hoko, and J. Kashaigili. "Sludge characterization at Kadahokwa water treatment plant, Rwanda." Water Supply 10, no. 5 (2010): 848–59. http://dx.doi.org/10.2166/ws.2010.377.
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A study was carried out to characterize the sludge produced at Kadahokwa Water Treatment Plant (KWTP) in Butare to assess the effectiveness of the sludge treatment and potential impacts of sludge disposal on the environment. Parameters analyzed were chromium, nickel, cadmium, lead, copper, zinc, iron, manganese, aluminium, total nitrogen, total phosphorus, potassium and cation exchange capacity (CEC). The results showed that 450±244.5 tons (dry weight) of sludge are produced annually. The concentrations of heavy metals in the sludge were below the standard limits for land application set by different countries. The high concentrations of nickel (42.3±2.5 ppm), chromium (29.9±6.2 ppm), cadmium (1.1±0.3 ppm) and lead (31.6±3.7 ppm) in the dried sludge posed a pollution risk for the wetland. The CEC was 28.4–33.3 cmol (+)/kg and pH was 6.50–7.45. It was concluded that the KWTP sludge is a poor source of total carbon, a moderate source of nutrients (NPK), and an important source of micronutrients, making it generally suitable for reuse for crop production. The CEC showed that the sludge could improve soil nutrient and water holding capacity. The higher concentration of aluminium (280 ppm) in the sludge creates an opportunity for recycling.
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Lansigan, Frederick, Cristiana A. Costa, Egide Mpanumusingo, et al. "A novel global health fellowship elective in oncology in Rwanda: A multi-faceted model in education." Journal of Clinical Oncology 35, no. 15_suppl (2017): e18086-e18086. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18086.
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e18086 Background: Despite the rising burden of cancer, opportunities for global health education (GHE) at the fellowship level are lacking in hematology and oncology (HO). The Geisel School of Medicine at Dartmouth (GSMD) is pioneering a supervised one-month elective in Rwanda for HO fellows enrolled in U.S. programs. The goals are to expose fellows to a wider spectrum of disease states, improve clinical acumen, cultural sensitivity, and learn about health delivery in low-resource countries, while providing educational support for the local staff in a multidirectional learning paradigm. Methods: In partnership with the Rwandan Ministry of Health (MOH) and Partners in Health (PIH), GSMD created a one month elective rotation at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda. HO Fellows with an interest in GHE apply to work in the outpatient clinic and inpatient wards in at BCCOE under direct supervision by GSMD faculty to provide input on cancer management including diagnosis, treatment, and chemotherapy administration. Fellows and attendings give lectures to hospital faculty and staff on topics requested by the leadership of BCCOE and participate in weekly telemedicine tumor boards. Fellows are evaluated using ACGME clinical competencies. Feedback from the Rwandan staff is obtained through customized evaluations. Results: The HO fellow gained exposure to advanced cancers including HIV-related malignancies, rare sarcomas and gestational trophoblastic disease, adhered to locally developed staging and treatment pathways, and gained confidence in guiding medical decisions. Fellows and faculty gave didactic presentations and provided bedside teaching. The local MOH and PIH staff gained new insight about approaches to management of complex disease states. This program promoted a multidirectional exchange of ideas related to patient care, disease states, and collaborative research projects. Conclusions: The institution of a global health fellowship elective in oncology has measurable benefits to HO fellows, cancer care providers in Rwanda and American faculty sub-specialists. This novel educational program will help to bridge the gap in global health disparities in a multifaceted approach.
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Rubagumya, Fidel, Ainhoa Costas-Chavarri, Achille Manirakiza, et al. "State of Cancer Control in Rwanda: Past, Present, and Future Opportunities." JCO Global Oncology, no. 6 (September 2020): 1171–77. http://dx.doi.org/10.1200/go.20.00281.
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Rwanda is a densely populated low-income country in East Africa. Previously considered a failed state after the genocide against the Tutsi in 1994, Rwanda has seen remarkable growth over the past 2 decades. Health care in Rwanda is predominantly delivered through public hospitals and is emerging in the private sector. More than 80% of patients are covered by community-based health insurance (Mutuelle de Santé). The cancer unit at the Rwanda Biomedical Center (a branch of the Ministry of Health) is responsible for setting and implementing cancer care policy. Rwanda has made progress with human papillomavirus (HPV) and hepatitis B vaccination. Recently, the cancer unit at the Rwanda Biomedical Center launched the country’s 5-year National Cancer Control Plan. Over the past decade, patients with cancer have been able to receive chemotherapy at Butaro Cancer Center, and recently, the Rwanda Cancer Center was launched with 2 linear accelerator radiotherapy machines, which greatly reduced the number of referrals for treatment abroad. Palliative care services are increasing in Rwanda. A cancer registry has now been strengthened, and more clinicians are becoming active in cancer research. Despite these advances, there is still substantial work to be done and there are many outstanding challenges, including the need to build capacity in cancer awareness among the general population (and shift toward earlier diagnosis), cancer care workforce (more in-country training programs are needed), and research.
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Francois, U., J. P. Balinda, M. Hagenimana, R. Samuel, E. Arielle, and M. A. Muhimpundu. "Scaling Up of Cervical Cancer Screening at Primary Health Care Level in Rwanda." Journal of Global Oncology 4, Supplement 2 (2018): 54s. http://dx.doi.org/10.1200/jgo.18.78700.
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Background: Rwanda is a high cervical cancer-burden country, with an age standardized rate (ASR) of cervical cancer incidence of 41.8 cases per 100,000 people in 2012. In the same year, cervical cancer mortality lay at 26.2 deaths per 100,000 people. Aim: To address this burden, Rwanda initiated the vision inspection with acetic acid (VIA) screening-based strategy in 2013 in line with WHO recommendations for low- and middle-income countries. The target audience of the program was set for women between the ages of 30 and 49 and remains today. Here, we describe the implementation status of the program at the primary health care level; health centers and district hospitals in Rwanda. Methods: Integrating into Rwanda's existing health system, the program was purposefully rooted in health centers, with a pathway designed for women who screen positive to be referred to the district hospital for cryotherapy or LEEP, according to the lesions' size. Nurses, midwives and medical officers from health centers and district hospitals are trained through a 10-day curriculum (5 days for theory and 5 days for practice) before initiating the provision of services to clients in routine care. Monitoring of the program is conducted through both quarterly, on-site mentorship and screening indicators that are integrated into Rwanda's Health Management Information System (HMIS), through which facilities report on monthly basis. Results: Since its initiation in August 2013, Rwanda's cervical cancer screening program has been established in 21 of 38 (55%) district hospitals and 256 health centers in their catchment area. Training has been an integral component as well, with at least two nurses/midwives trained at implementing health centers and a medical officer with two nurses/midwives trained on cervical cancer screening and the treatment of precancerous lesions at district hospital. In addition, district hospitals have been equipped with cryotherapy, LEEP, and colposcopy machines. Over this program's implementation three-and-a-half-year course, 38,000 women have been screened for cervical cancer. Conclusion: Using a simple VIA-based strategy, Rwanda has been able to swiftly and effectively increase the number of health facilities implementing cervical cancer screening program. Though additional innovative implementation strategies are still needed to proportionally increase women's screening coverage, these initial steps hold great promise in Rwanda's ability to effectively implement a sustainable cervical cancer screening program.
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Chemouni, Benjamin, and Assumpta Mugiraneza. "Ideology and interests in the Rwandan patriotic front: Singing the struggle in pre-genocide Rwanda." African Affairs 119, no. 474 (2019): 115–40. http://dx.doi.org/10.1093/afraf/adz017.
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Abstract In the study of African Politics, the analysis of political ideologies as a normative engine of political action seems to have receded in favour of a treatment of ideology as the support of actors in their pursuit of material interests. Rwanda is not an exception. The ideology of the ruling Rwandan Patriotic Front (RPF) has been predominantly analysed as a self-serving strategy geared towards the reinforcement of the party’s power. Such treatment of ideology prevents a full understanding of the RPF. This article argues that ideology should also be conceptualized as a matrix that can reshape material incentives and through which the RPF’s interests have emerged. To do so, the article analyses new sources of material, the songs of mobilization from RPF members and supporters composed before the Front took power during the genocide, to systematically delineate the RPF’s early ideology. The analysis centres on four main themes—Rwandan national unity, the RPF’s depiction of itself, its depiction of its enemy, and its relationship with the international community—and traces their influence on RPF interests in the post-genocide era. It reveals the surprisingly long-lasting power of ideas despite fast-changing material circumstances.
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Mazimpaka, Christian, Sabin Nsanzimana, Jenae Logan, Agnes Binagwaho, and Rex Wong. "Assessing the Magnitude and Risk Factors Associated With Undiagnosed Hypertension in Rural Rwanda." Journal of Management and Strategy 10, no. 2 (2019): 3. http://dx.doi.org/10.5430/jms.v10n2p3.
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Individuals living with hypertension are predisposed to higher risk of stroke, kidney diseases and heart failure. Approximately 9.4 million people worldwide die from complications related to hypertension every year. Hypertension is often known as the silent killer because many people do not develop any symptoms until they get very sick. Early screening is particularly important for better treatment outcomes yet it remains a challenge in many countries. Worldwide, approximately 50% of people are living with undiagnosed hypertension. In Rwanda, the rate of undiagnosed hypertension is unknown, and so are the associated risk factors in rural communities. A cross-sectional descriptive study was conducted to determine the rate and risk factors of undiagnosed hypertension among adults in a rural community in Rwanda. The proportion of people having undiagnosed hypertension was found to be high. Out of 155 study participants, 41.9% had undiagnosed hypertension, with slightly more men having hypertension (52.3%) than women (47.7%). More than 98% of respondents either did not know or knew wrong information about hypertension, and only 3% knew they should have regular checkups with physicians. Age (p=0.027) and alcohol consumption (p=0.014) were found to be statistically significantly associated with hypertension. Smoking and exercise were not found to be risk factors as most Rwandans living in the rural areas are physically active. Programs to promote hypertension awareness, encourage regular physical checkups, and reduce alcohol consumption are needed to improve diagnosis and control of hypertension in Rwanda. Community programs offering free regular blood pressure checks may also be helpful in identifying early hypertension. Larger scale studies of this kind should be conducted to understand whether results can be generalized to other areas of Rwanda.
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Karema, Corine, Mallika Imwong, Caterina I. Fanello, et al. "Molecular Correlates of High-Level Antifolate Resistance in Rwandan Children with Plasmodium falciparum Malaria." Antimicrobial Agents and Chemotherapy 54, no. 1 (2009): 477–83. http://dx.doi.org/10.1128/aac.00498-09.
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ABSTRACT Antifolate drugs have an important role in the treatment of malaria. Polymorphisms in the genes encoding the dihydrofolate reductase and dihydropteroate synthetase enzymes cause resistance to the antifol and sulfa drugs, respectively. Rwanda has the highest levels of antimalarial drug resistance in Africa. We correlated the efficacy of chlorproguanil-dapsone plus artesunate (CPG-DDS+A) and amodiaquine plus sulfadoxine-pyrimethamine (AQ+SP) in children with uncomplicated malaria caused by Plasmodium falciparum parasites with p fdhfr and p fdhps mutations, which are known to confer reduced drug susceptibility, in two areas of Rwanda. In the eastern province, where the cure rates were low, over 75% of isolates had three or more p fdhfr mutations and two or three p fdhps mutations and 11% had the p fdhfr 164-Leu polymorphism. In the western province, where the cure rates were significantly higher (P < 0.001), the prevalence of multiple resistance mutations was lower and the p fdhfr I164L polymorphism was not found. The risk of treatment failure following the administration of AQ+SP more than doubled for each additional p fdhfr resistance mutation (odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.01 to 5.55; P = 0.048) and each p fdhps mutation (OR = 2.1; 95% CI = 1.21 to 3.54; P = 0.008). The risk of failure following CPG-DDS+A treatment was 2.2 times higher (95% CI = 1.34 to 3.7) for each additional p fdhfr mutation, whereas there was no association with mutations in the p fdhps gene (P = 0.13). The p fdhfr 164-Leu polymorphism is prevalent in eastern Rwanda. Antimalarial treatments with currently available antifol-sulfa combinations are no longer effective in Rwanda because of high-level resistance.
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Ngabonziza, J.-C. S., Y. M. Habimana, T. Decroo, et al. "Reduction of diagnostic and treatment delays reduces rifampicin-resistant tuberculosis mortality in Rwanda." International Journal of Tuberculosis and Lung Disease 24, no. 3 (2020): 329–39. http://dx.doi.org/10.5588/ijtld.19.0298.
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SETTING: In 2005, in response to the increasing prevalence of rifampicin-resistant tuberculosis (RR-TB) and poor treatment outcomes, Rwanda initiated the programmatic management of RR-TB, including expanded access to systematic rifampicin drug susceptibility testing (DST) and standardised treatment.OBJECTIVE: To describe trends in diagnostic and treatment delays and estimate their effect on RR-TB mortality.DESIGN: Retrospective analysis of individual-level data including 748 (85.4%) of 876 patients diagnosed with RR-TB notified to the World Health Organization between 1 July 2005 and 31 December 2016 in Rwanda. Logistic regression was used to estimate the effect of diagnostic and therapeutic delays on RR-TB mortality.RESULTS: Between 2006 and 2016, the median diagnostic delay significantly decreased from 88 days to 1 day, and the therapeutic delay from 76 days to 3 days. Simultaneously, RR-TB mortality significantly decreased from 30.8% in 2006 to 6.9% in 2016. Total delay in starting multidrug-resistant TB (MDR-TB) treatment of more than 100 days was associated with more than two-fold higher odds for dying. When delays were long, empirical RR-TB treatment initiation was associated with a lower mortality.CONCLUSION: The reduction of diagnostic and treatment delays reduced RR-TB mortality. We anticipate that universal testing for RR-TB, short diagnostic and therapeutic delays and effective standardised MDR-TB treatment will further decrease RR-TB mortality in Rwanda.
Dissertations / Theses on the topic "Treatment, Rwanda"
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Twagirayezu, Jacques. "Assessment and treatment choices of physiotherapists treating non-specific low back pain in Rwanda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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The aim of this study was to determine assessment and treatment choices of physiotherapists treating non-specific low back pain in Rwanda. The main objectives were to identify the common types of low back pain treated by physiotherapists, to determine the
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Uwimana, Jeannine. "Met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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The aim of this study was to investigate met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda. The achieve this aim, the study, firstly, identified the palliative care needs of people living with HIV/AIDS, secondly, it identified the health care services available to meet these needs, and thirdly, it determined the extent to which palliative care needs were met.
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Twizere, Janvier. "Epidemiology of soccer injuries in Rwanda: A need for physiotherapy intervention." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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Being involved in soccer in Rwanda at both national and international level exposes soccer players to the risk of injury. The aim of this study was to identify common soccer injuries among the 1st and 2nd division soccer teams in Rwanda and to establish the need for physiotherapy intervention. This deals with the first two stages of injury prevention, which included identification and description of the extent of the problem and the identification of factors and mechanisms that play a part in the occurrence of injuries.
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Hakizimana, Moussa. "Epidemiology and management of basketball related injuries in Rwanda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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Basketball continues to increase in popularity worldwide as a participation sport at all levels of play, from recreational to professional. Each year, more than 1.6 million basketball-related injuries are treated in hospitals, doctor's offices and emergency rooms in North America. In Rwanda, basketball and volleyball are the second popular sports, following football. The aim of the study was to investigate the prevalence, mechanisms, nature and management of basketball-related injuries in Rwanda.
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Kabeja, Adeline. "Effectiveness of task shifting in antiretroviral treatment services in health centres, Gasabo district, Rwanda." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4049.
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Magister Public Health - MPH<br>In the context of human resource crisis in African countries, the World Health Organization has proposed task-shifting as an approach to meet the ever-increasing need for HIV/AIDS care and treatment services. Rwanda started the process of task shifting towards nurse-based care in ART services in June 2010. After one year of implementation, a need to determine whether task shifting program has been implemented as intended and if it achieved its primary goal of
increasing accessibility of people living with HIV to ARV therapy and improving nurse capacity in HIV patient care was imperative.A multi-method program evaluation study design, combining cross sectional, retrospective review and retrospective cohort sub-studies were used to evaluate the implementation,maintenance processes and outcomes of task shifting in 13 Health Centres (HCs) located in the catchment area of Kibagabaga District Hospital, in Rwanda. The study population consisted of HCs providing task shifted care (n=13), nurses working in the ART services of the 13 HCs(n=36), and more than 9,000 patients enrolled in ART care in the 13 HCs since 2006. All 13 HCs and 36 nurses were included in the evaluation. Routine data on patients enrolled in the pre-task
shifting period (n=6 876) were compared with the post task shifting period (n=2 159), with a specific focus on data in the 20-months periods prior to and after task shifting. A cohort of patients 15 years and older, initiated onto ART specifically by nurses from June to December 2010 was sampled (n=170) and data extracted from patients medical files.Data collection was guided by a set of selected indicators. Three different data collection tools were used to extract data related to planning, overall programmatic data and individual data from respectively, the program action plans/reports, HIV central databases and patients medical files.
Descriptive analysis was performed using frequencies, means and standard deviations (SD). The paired and un-paired t-tests were used to compare means, and chi-square test was used to compare categorical variables. To compare and to test statistical difference between two repeated measurements on a single sample but with non-normally distributed data, Wilcoxon signed rank test was used. To judge if current task shifted care is better, similar or worse than non-task
shifted care, comparisons were made of program outputs and outcomes from the central database prior to and after the period of task shifting, and also with the cohort of nurse initiated patients.Results showed that 61% of nurses working in the ART program were fully trained and certificated to provide ART. Seven out of 13 HCs met the target of a minimum of 2 nurses trained in ART service delivery. Supervision and mentorship systems for the 13 HCs were well organized on paper, although no evidence documenting visits by mentors from the local district
hospital to clinics was found. In term of accessibility, the mean number of patients newly initiated on ART per month in the HCs increased significantly, from 77.8/month (SD=22.7) to 93.9/month (SD=20.9) (t test (df=38), p=0.025). A small minority of patients was enrolled in late stages of HIV, with only 15% of the patient cohort having CD4 counts of less than 100 cell /μL at initiation on ART. The baseline median CD4 cell count was 267.5 cells /μL in the cohort as a whole. With respect to quality of care, only 8.8% of patients in the cohort had respected all
appointments over a mean follow up period of 17.2 months; and although follow up CD4 counts had been performed on the majority of patients (80%), it was done after a mean of 8.5 months(SD=2.7) on ART, and only a quarter (24.7%) had been tested by 6 months (as stipulated by guidelines). From central ART program data, a small but significant increase of patients on 2nd line drugs was observed after implementation of task shifting (from 1.98% to 3.00%, 2=13.26,p<0.001), although the meaning of this shift is not entirely clear.The median weight gain was 1 kg and median CD4 increase was 89.5 cells /μL in the cohort after 6 months of receiving task shifted care and treatment. These increases were statistically
significant for both male and female patients (Wilcoxon signed rank test, p<0.001). With regard to loss to follow up, only three of the 170 patients in the cohort followed up by nurses had been lost to follow-up after a mean of 17.2 months on treatment. The routine data showed a decrease of patients lost to follow up, from 7.0% in the pre-task shifting period to 2.5% in the post-task shifting period. In general, the mortality rate was slightly lower in the post-task shifting period
than in the pre-task shifting (5.5% vs 6.9% respectively), although this was not statistically significant (2=2.4, df=1, p=0.1209).This study indicates that, after over one year of implementation of task shifting, task shifting enabled the transfer of required capacity to a relatively high number of nurses. In an already well
established programme, task shifting achieved moderate improvements in uptake (access) to ART, significant reductions in loss to follow up, and good clinical outcomes. However,evaluation of process quality highlighted some concerns with respect to adherence to testing guidelines on the part of providers and follow up visits on the part of patients. Improvements in processes of monitoring and follow up are imperative for optimal mid-term and long-term task shifting in the ART program.
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Lela, Mukaruzima. "The relationship between physical activity and low back pain among nurses in Kanombe Military Hospital." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3554_1307534535.
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<p>The aim of the current study was to determine the relationship between low back pain and physical activity levels among nurses in Kanombe Military Hospital (KMH), as well as other confounding factors leading to low back pain. A quantitative, cross-sectional and descriptive design was used to conduct the study. The study population and sample included all clinical nurses in all the departments/wards at KMH (excluding three nurses doing administrative work only and the four who participated in the pilot study). A total of 133 nurses participated in the study and data was collected using three self administered questionnaires. The first one requested socio-demographic data, followed by the International Physical Activity Questionnaire (IPAQ) which examined the physical activity levels of nurses, and lastly the Nordic Musculoskeletal Disorder Questionnaire which examined low back pain prevalence. A response rate of 122 (92%) was obtained.</p>
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Umubyeyi, Nyaruhirira Alaine. "Apport de la microbiologie dans la prise en charge thérapeutique de la tuberculose au Rwanda." Doctoral thesis, Universite Libre de Bruxelles, 2007. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209231.
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Hategekimana, Celestin. "Evaluating the implementation of the emergency, triage, assessment and treatment plus admission care intervention in Rwanda." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/55056.
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Background: Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+) intervention – a locally adapted pediatric advanced life support program – introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The current thesis was undertaken as part of a larger program of research that aims to evaluate the ETAT+ implementation in Rwanda.
Methods: Data were gathered during a cross-sectional study in 8 district hospitals across Rwanda; an audit in these hospitals was undertaken to establish a baseline description of the availability of essential resources and process of care related to the leading causes of under-five mortality in Rwanda. To determine changes in participating healthcare providers’ knowledge and practical skills (n=374) between pre- and post ETAT+ implementation, a one group pre-posttest design was used. Paired t-test was used to assess the effect of ETAT+ training on knowledge improvement; and, linear and logistic regression models were fitted to examine factors associated with healthcare providers’ performance on ETAT+ knowledge and skills assessments in Rwanda.
Results: Baseline assessment reveals some deficiencies in processes of care (i.e. assessment, treatment and follow-up care), poor organization of some hospital services (e.g., triage), and poor uptake of current pediatric clinical practice guidelines (e.g., dehydration). Post ETAT+, participants’ knowledge scores improved on average by 22.8% (95% CI 20.5, 25.1). Compared to participants who identified as proficient in French, those who identified as proficient in both English and French had on average a higher improvement in knowledge (least square mean=6.64; 95% CI 3.79, 9.49) and were more likely to pass the practical skills assessment (adjusted odds ratio=2.58; 95% CI 1.28, 5.48).
Conclusions: The audit of medical records reveals gaps in the process of pediatric care; and these gaps were found to be consistent with knowledge gaps among healthcare providers, as assessed through the ETAT+ pre-assessment. Improvements in post-ETAT+ performance were significant and a number of factors (e.g., language barriers) were identified as important influences on ETAT+ training outcomes. These factors need to be taken in account when implementing ETAT+ and other continuing medical education interventions within the Rwandan context.<br>Medicine, Faculty of<br>Population and Public Health (SPPH), School of<br>Graduate
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Tellez, Sanchez Sarita Lucia. "Household Water Filter Use Characterization in Rural Rwanda: Signal Interpretation, Development and Validation." PDXScholar, 2016. http://pdxscholar.library.pdx.edu/open_access_etds/3026.
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Access to safe drinking water is an important health factor in many developing countries. Studies have shown that unsafe drinking water and poor sanitation practices leads to diarrheal disease, which is one of the leading causes of death of children under five in developing countries. Provision and proper use of household water filters have been shown to effectively improve health.
This thesis is focused on the refinement and validation of algorithms for data collected from pressure transducer sensors that are used in household water filters (the Vestergaard Frandsen LifeStraw Family 2.0) deployed in Rwanda by the social enterprise DelAgua Health. Statistical and signal processing techniques were used to detect the use of the LifeStraw water filters and to estimate the amount of water filtered at the time of usage. An algorithm developed by Dr. Carson Wick at Georgia Institute of Technology was the baseline for the analysis of the data. The algorithm was then refined based on data collected in the SweetLab at Portland State University, which was then applied to field data.
Laboratory results indicated that the mean error of the improved algorithm is 11.5% as compared with the baseline algorithm mean error of 39%. The validation of the algorithm with field data yielded a mean error of 5%. Errors may be attributed to real-world behavior of the water filter, electronic noise, ambient temperature, and variations in the approximation made to the field data. This work also presents some consideration of the algorithm applied to soft-sided water backpacks.
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O'Connell, Bethesda, Deborah Slawson, Megan Quinn, Phillip R. Scheuerman, and Olushola Ogunleye. "Biosand Water Filter Evaluation: Pilot Study of Field Use Indicators in Cyegera, Rwanda." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5481.
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Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. There is no generally agreed-upon field method for determining biosand water filter effectiveness that is usable in low-resource communities. A pilot study was conducted of potential field use indicators, including the Colilert coliform presence/absence (P/A) test, hydrogen sulfide, alkalinity, hardness, pH, and fluorescently labeled latex microspheres. The study included both laboratory and field testing. The Colilert P/A test had the highest correlation to the United States Environmental Protection Agency standard method (IDEXX Quanti-trays), but more data are needed before making a recommendation. This study adds to understanding about evaluation of biosand water filters and provides preliminary data to address the need for a field use indicator for biosand water filters.
Books on the topic "Treatment, Rwanda"
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Programme national intégré de lutte contre le paludisme (Rwanda). Plan stratégique "Faire reculer le paludisme au Rwanda" 2005-2010. Ministère de la santé, Programme national intégré de lutte contre le paludisme, 2005.
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Darcy, Shane. The Principle of Legality at the Crossroads of Human Rights and International Criminal Law. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190272654.003.0012.
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This chapter explores the treatment of the principle of legality in international criminal law, in particular the rule against ex post facto application of criminal laws, as enshrined in human rights law. It demonstrates that a broadly liberal interpretation of nullum crimen has facilitated judicial creativity and the development of international criminal law by international courts and tribunals. The chapter begins with a general discussion of the principle of legality under international law, before turning to a consideration of the treatment of the principle at Nuremberg and the ad hoc international criminal tribunals for Rwanda and the former Yugoslavia. The final section of the chapter turns to the European Court of Human Rights and examines how it has addressed the rule of non-retroactivity in the context of national prosecutions of international crimes, in particular in Kononov v. Latvia.
Book chapters on the topic "Treatment, Rwanda"
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Fournet, Caroline. "Nothing Must Remain." In Perpetrators of International Crimes. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198829997.003.0014.
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An intrinsic and material consequence of mass violence is the corresponding mass production of human corpses. What the perpetrators subsequently do with these corpses varies greatly from one instance to another, and the rationale behind their choice and behaviour is not always clear. If establishing an infallible typology of the treatment of corpses of the victims by the perpetrators thus holds the risk of leading to erroneous extrapolations, the different modalities of treatment all seem to share one point: the use by the perpetrators of the corpses of their victims to make their crimes visible or, to the contrary, to hide them. Focusing on selected cases (Bosnia-Herzegovina, Rwanda, Argentina), this contribution explores how treatments of corpses as diverse as exhibition, mutilation, concealment, or destruction are seldom a random choice and reveal the perverse relationship between perpetrators, violence, and death; between what they show and what they hide.
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"Chapter 5. The International Criminal Tribunal For Rwanda And Its Treatment Of Crimes Against Women." In International Humanitarian Law: Challenges. Brill | Nijhoff, 2006. http://dx.doi.org/10.1163/ej.9781571052674.i-1142.130.
Full textConference papers on the topic "Treatment, Rwanda"
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Umutoni, Victoria, Cyprien Shyirambere, Ethan Katznelson, et al. "Abstract 46: Clinical Outcomes and Quality Metrics of Cervical Cancer Treatment in Rwanda." In Abstracts: 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; March 10-11, 2021. American Association for Cancer Research, 2021. http://dx.doi.org/10.1158/1538-7755.asgcr21-46.
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Nyirahabimana, Naome, Jean D’Amour Ndahimana, Jenae Logan, Fredrick Kateera, and Rex Wong. "P436 Barriers to adherence to HIV treatment among adolescents and youth enrolled in ARV in two district hospitals in rural Rwanda." In Abstracts for the STI & HIV World Congress (Joint Meeting of the 23rd ISSTDR and 20th IUSTI), July 14–17, 2019, Vancouver, Canada. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/sextrans-2019-sti.522.
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Fadelu, Temidayo, Cam Nguyen, Nicaise Nsabimana, et al. "Abstract 67: Quantifying Transportation Barriers in Rwandan Patients Seeking Treatment for Breast Cancer." In Abstracts: 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; March 10-11, 2021. American Association for Cancer Research, 2021. http://dx.doi.org/10.1158/1538-7755.asgcr21-67.
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